Patients face large bills as air ambulance rides proliferate: 5 things to know

As the number of air ambulance flights in the U.S. has nearly doubled in recent years, it is more common for patients to encounter high medical expenses due to billing disputes, rising flight prices and loopholes in federal law, according to a Bloombergreport.

Here are five things to know:

1. Air ambulances have proliferated over the last 15 years, nearly doubling in number to nearly 900 helicopters making 300,000 flights each year, according to the report, which cites data compiled by Ira Blumen, a professor of emergency medicine and director of University of Chicago Aeromedical Network. Data showed the number of patients flown per helicopter has not expanded at the same pace.

2. The growth of air ambulances has resulted in high bills for a number of patients and families. The report cites a specific case in West Virginia where 3-year-old West Cox, whose fever hit 107 degrees, was flown 76 miles from the Princeton (W. Va.) Community Hospital to CAMC Women and Children's Hospital in Charleston, W. Va. After the toddler recovered from apparent encephalitis, his parents received a bill for $45,930 from for-profit helicopter operator Air Methods, according to the report. A legal dispute between the Cox family and Air Methods is ongoing.

3. The Cox family's case, and various similar cases, centers on a specific issue: Air ambulances charge an amount they deem necessary for operating their business, and patients are put on the hook for remaining costs not covered by Medicare, Medicaid or private insurers.

4. Prices and federal law contribute to the issue. Under federal law, air ambulances are considered air carriers and have few restrictions on the amount they can charge for rides, reports Bloomberg. This means states can do little to help curb air ambulance rates, although various states have tried to do so unsuccessfully. At the same time, the report states, prices for emergency medical flights have significantly risen as air ambulances have proliferated and now respond to a greater variation of emergencies. A U.S. Government Accountability Office report cited by Bloomberg showed the median charge to Medicare for an air ambulance flight more than doubled from $14,000 in 2010 to nearly $30,000 in 2014.

5. The air ambulance industry argues that part of the problem stems from insurers not agreeing to network contracts, while consumer groups and insurers argue air ambulance companies remain out of health plan networks for their own financial gain, according to the report.